Individual
KRISTY SHEPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 E AZTEC AVE, GALLUP, NM 87301-5509
(505) 721-1800
(505) 721-1899
Mailing address
1000 E AZTEC AVE, GALLUP, NM 87301-5509
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
293043
NM
Other
Enumeration date
08/03/2016
Last updated
08/03/2016
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